Irene Smith
Sep 2, 2018 · 3 min read

Beyond Massage

I am saddened when I hear hospice massage practitioners speak about their coordinators alerting them that their client no longer needs them when the client transitions into late stages of their dying process. Practitioners also speak to no longer seeing clients because they become to fragile or because they can no longer communicate verbally. This alerts me to the possibility that hospice coordinators and many practitioners are unaware of the range of possibilities and benefits of touch at the end of life.

Yes. Beneath the massage technique is the organic gift of touch. Touch provides support and facilitates positive outcomes that are many times unspoken in the hospice or massage community. In this report of one of my last visits with a client named Mary I speak to multiple benefits of having a touch practitioner in the room with the dying person who is in a late stage of their dying process.

When I entered the room I saw that Mary had gone through another change in her body. She was on her final journey.

Mary,s eyes were open looking straight ahead and her mouth was open for easier breathing. The breath had created very dry chapped lips however Mary,s breathing was clear and open. There was no struggle. The breath was peaceful.Mary’s nurse Patty was sitting across the room. We smiled and said hello as I sat down by the bed next to Mary’s head .

I spoke to Mary observing her breathing and her open mouth that had created a locked facial structure. When I felt permission, I began stroking Mary’s face and jaw very gently and very slowly.Touching Mary’s chin gently I spoke of her face becoming easy, soft and her mouth resting just resting. I spoke very slowly while slowly stroking Mary,s face and jaw. I also included Mary,s sternum just to encourage gentle easy breaths.

Mary’s whole body started to respond by a softening of the jaw and the cheeks of her face started to relax. Mary’s mouth closed just a little bit and this softened her eyes. Mary's exhales became longer and slower and Mary’s legs began to rest at the knees.

I suggested that Patty try and find some sponges to dampen Mary’s mouth . Mary ‘s mouth was very dry and cracked from being open so long.

When Patty returned she hydrated Mary's lips and mouth and sat by the bed with us. I showed Patty how to gently stroke Mary,s face, jaw and speak to encourage the face to stay soft. As I guided Patty the connection between the three of us deepened . The connection was comfortable, easy and welcomed.

How wonderful that Patty was left with some skills that assisted her to stay connected to Mary; ease her own feelings of helplessness and give Patty a way to stay connected and nurtured in her role.

How fortunate for Mary that someone was there who was skillful in assisting the body in remaining calm , soft and easy. The skill of calm presence, tender focused touch, and verbal direction are paramount at the end of someone’s life. These cultivated skills are invaluable for the patient, the family and for the health care provider.

To be a massage practitioner in hospice care models the wide range of positive outcomes from touch and focused presence. Most often in my 36 year practice the late stages have been when my services have been most in demand.

Learning about the massage practitioners role in hospice care beyond massage is truly learning to recognize the depth of the role.

This is a you tube link to me telling this story live https://www.youtube.com/watch?v=Q7H_qdxKUQo

Blessings,

Irene Smith CMP

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